New initiative launched to help find metabolic and liver disease earlier

Somerset NHS Foundation Trust has launched a new preventative approach to help identify people who may be at risk of liver disease and wider metabolic ill health earlier, before they develop serious complications.

The pathway, supported through Somerset’s Community Diagnostic Centre programme, which is designed to improve access to medical imaging and tests, will use hepatoSIGHT, a digital case-finding tool developed by Predictive Health Intelligence, whose initial development was funded by the National Institute for Health and Care Research (NIHR), to analyse existing blood test results and identify people who may benefit from further liver checks.

Liver disease often develops silently, with few or no obvious symptoms until it has already progressed.

It is also closely linked to wider health issues, including obesity, type 2 diabetes and cardiovascular risk.

By identifying people with signs of liver damage earlier, the pathway aims to support earlier intervention for a group of patients who may otherwise only come to clinical attention once they are much more unwell.

The project supports work to improve cancer prevention and earlier diagnosis. Advanced liver disease is a major risk factor for liver cancer, but many people with significant liver damage are not identified until the opportunity for earlier intervention has narrowed.

Finding people with progressive liver disease earlier creates an opportunity to provide advice, treatment, monitoring or specialist care before avoidable complications develop.

This approach will also help Somerset NHS Foundation Trust address health inequalities.

Liver disease and metabolic ill health do not affect all communities equally, and people at highest risk may not always be those most likely to come forward through traditional referral routes.

By using data on deprivation and historic NHS test results to proactively identify people who may benefit from further checks, this approach can help services reach people earlier and more systematically.

The project builds on previous research and pilot work in Somerset and marks the next step in bringing earlier liver disease identification into routine clinical care.

During an earlier pilot, the team wrote to around 700 people inviting them for further testing, with hundreds now receiving meaningful treatment that could add decades to their life expectancy.

The new pathway is expected to significantly increase this, with around 9,000 people potentially invited for further checks as the pathway develops.

People identified may be invited for further blood tests or a specialist liver scan, which can help assess whether there is scarring or fat in the liver.

If the scan suggests they need specialist care, they can then be referred to the right clinical team.

If no significant liver scarring is found, their GP will be updated and patients may be signposted to advice and support to help reduce future liver and metabolic risk.

Dr Tim Jobson, consultant gastroenterologist at Somerset NHS Foundation Trust, said: “Liver disease is often difficult to spot early because many people do not have clear symptoms.

“But existing blood tests can contain important signals that someone may benefit from further investigation.

“hepatoSIGHT helps us look for those patterns at scale. This means we can identify people who may need additional checks earlier, rather than waiting until they become unwell or are referred to specialist services with more advanced disease.

“This is not just about liver disease, it is about prevention, metabolic health, cancer risk and health inequalities. Liver issues can be an early warning sign that someone is at risk of more serious health problems, and finding that risk earlier gives us a chance to act.”

The pathway has been designed to sit between primary and secondary care, as case-finding does not fit neatly into existing GP or hospital pathways.

By using Community Diagnostic Centre investment, Somerset NHS Foundation Trust aims to create a more cost-effective and streamlined model.

The pathway will help identify people who need further tests, reduce avoidable referrals into specialist services, and make sure patients who do need specialist liver care are found earlier.

Somerset NHS Foundation Trust will evaluate the pathway as it develops, helping to understand how best to identify people at risk, support earlier intervention, and reduce avoidable pressure on specialist services.

The trust hopes the approach could also provide a model for other Community Diagnostic Centres, helping more areas use the available diagnostic investment to improve outcomes for people with liver disease, metabolic risk and related long-term conditions.